Intraoperative Assessment in Revision Total Knee Arthroplasty

by James A. Rand, Michael D. Ries, G. H. Landis, Aaron G. Rosenberg, and S. Haas

J Bone Joint Surg AmVolume 85(suppl 1):S26-S37

January 1, 2003

©2003 by The Journal of Bone and Joint Surgery, Inc.

The vascular anatomy of the knee skin.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Vascular supply to the skin is through the subdermal plexus.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Figs. 3-A and 3-B Gastrocnemius myocutaneous flap used in prophylactic staged reconstruction.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Healed flap prior to total knee arthroplasty.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

FIgs. 4-A, 4-B, and 4-C Saphenous fasciocutaneous flap used to reconstruct skin, the patella, and the extensor tendon for knee arthrodesis and limb salvage.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Flap.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Flap placed.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

FIgs. 5-A, 5-B, and 5-C Anterolateral thigh free flap used to treat skin compromise and chronic infection.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Flap at the time of removal of the antibiotic spacer.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Healed wound.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

A quadriceps snip consists of an oblique incision across the rectus femoris tendon in a proximal-lateral direction.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

The V-Y quadricepsplasty consists of an oblique incision across the rectus femoris tendon in a distal-lateral direction, which can be closed as a Y, lengthening the tendon.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

The bone cut (A) and the exposure achieved and wire placement for closure (B) for the tibial tubercle osteotomy.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

The medial epicondylar osteotomy.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Intraoperative view of a tibial defect after débridement of an osteolytic defect and preparation of bone cuts.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Morselized allograft is packed around the tibial stem to fill the defect.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Type-III bone defect following implant and cement removal.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Structural femoral allograft prepared for revision.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Distal femoral allograft fixed with cables.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.

Morselized allograft in cavitary bone defects.

James A. Rand et al. J Bone Joint Surg Am 2003;85:S26-S37

©2003 by The Journal of Bone and Joint Surgery, Inc.